Korean J Ophthalmol.  2008 Jun;22(2):143-144. 10.3341/kjo.2008.22.2.143.

Cytomegalovirus Retinitis After Intravitreous Triamcinolone Injection in a Patient with Central Retinal Vein Occlusion

• Park YS
• Byeon SH

• KMID: 1099011
• DOI: http://doi.org/10.3341/kjo.2008.22.2.143

Abstract

To report a case of cytomegalovirus (CMV) retinitis after intravitreal injection of triamcinolone acetonide (IVTA). A 77-year-old woman with macular edema due to central retinal vein occlusion (CRVO) developed peripheral retinitis 4 months after IVTA. A diagnostic anterior chamber paracentesis was performed to obtain DNA for a polymerase chain reaction (PCR) test for viral retinitis. The PCR test was positive for CMV DNA. Other tests for infective uveitis and immune competence were negative. Four months after presentation, gancyclovir was intravitreously injected a total of 5 times, and the retinitis resolved completely. CMV retinitis is a rare complication of local immunosuppression with IVTA. It can be managed with timely injection of intravitreal gancyclovir until recovery from local immunosuppression.

Keyword

Cytomegalovirus; Gancyclovir; Immunosuppression; Retinitis; Triamcinolone

MeSH Terms

Aged
Antiviral Agents/therapeutic use
Cytomegalovirus/genetics
Cytomegalovirus Retinitis/diagnosis/drug therapy/*etiology
DNA, Viral/analysis
Female
Ganciclovir/therapeutic use
Humans
Immunosuppressive Agents/*adverse effects
Injections
Macular Edema/drug therapy/etiology
Polymerase Chain Reaction
Retinal Vein Occlusion/complications/*drug therapy
Triamcinolone Acetonide/*adverse effects
Vitreous Body

Figure

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  Fig. 1 Cytomegalovirus (CMV) retinitis 4 months after intravitreous injection of triamcinolone acetonide (IVTA). The patient initially presented with blurred vision and ghost vessels, multiple retinal hemorrhages, and peripheral retinitis.

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